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  • Rosa Emilia Moraes

What are the obstacles to organ donation in Brazil?

Refusal by the potential donor's family to authorize the process is the main cause of

transplants not being carried out. Training and transparency on the part of the medical team is essential, generating credibility for the service and contributing to raising awareness about organ donation and reducing the waiting list.


Article: Oliveira, A.F.C.G.; Cardoso, R.A.B.; Freitas, K.C.; Lotte, E.J.; Lucas, B.L. Lacunas e fatores impeditivos da doação de órgãos no Brasil: Revisão de literatura. Brazilian Journal of Transplantation, 2023.26 (01):e272.


What are the obstacles to organ donation in Brazil?

Brazil is a world reference when it comes to organ transplants, with 96% of surgeries carried out through the public health system. However, especially after the COVID-19 pandemic, there is an increasing discrepancy between the number of patients on the waiting list to receive an organ and the number of donors.

With the aim of exploring the factors that hinder and even prevent organ donation in Brazil, researchers from the Federal University of Jataí conducted a literature review that pointed to family refusal to authorize the process as the main obstacle to organ donations. The article "Gaps and impeding factors in organ donation in Brazil: Literature review", published in the Brazilian Journal of Transplantation (v. 26), also points to gaps in the systematization of donation and procurement, in relation to the diagnosis of brain death, making it difficult to identify potential donors. Papers available in the PubMed, EMBASE, Cochrane Library, Lilacs and SciELO databases, published in English and Portuguese between 2018 and 2022, were gathered. The discussion covers the legal aspects of organ donation and transplantation in Brazil, the context of brain death donation and medical knowledge about the diagnosis and its impact on the effectiveness of transplants. Special

emphasis was placed on the refusal of family members to authorize donation, and the reasons

why this happens.

According to Brazilian legislation (1997), it is exclusively up to the first-degree family of the potential donor to authorize the opening of the process. Between June and September 2022, family refusal was the reason for 46% of the cases in which donation did not take place, according to data from the Brazilian Transplant Registry (RBT).

The results examined by the authors indicate that dealing with ethical and moral issues, as well as clarity in the information to be passed on to family members, have a major influence on the decision to donate organs or not. It is therefore necessary for the team of professionals to be prepared to deal empathetically with the dilemmas faced by the family in such a delicate situation at a time of mourning. Awkward communication with the patient's relatives creates insecurity, while the support and clarification of well-educated professionals can really minimize the emotional turmoil and help overcome the loss of a loved one.

The training of medical staff is also important in order to suggest and develop new protocols for the effective diagnosis of brain death, reducing the time between distribution and organ procurement, contributing to greater efficiency in the system. The article highlights the importance of medical knowledge about brain death for the proper conduct of an efficient transplant process. The skills of the professionals involved are fundamental not only to the effectiveness of each individual process, but can also build credibility for the entire service,encouraging and sensitizing society to organ donation.


Read more (References):

Brasil. Associação Brasileira de Transplante de Órgãos. Registro Brasileiro de Transplantes.

São Paulo; 2022.

Brasil. Casa Civil. Lei 9.434, de 4 de fevereiro de 1997. Dispõe sobre a remoção de órgãos,

tecidos e partes do corpo humano para fins de transplante e tratamento e dá outras

providências. Brasília: Diário Oficial da União; 1997. [acesso em: 04 jul. 2022]. Disponível



Rosa Emilia Moraes, Scientific journalist at Linceu Editorial, São José dos Campos, SP, Brazil (



Brazilian Journal of Transplantation

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